Patients Preferred a Mini-posterior THA to a Contralateral Two-incision THA

The two-incision total hip arthroplasty (THA) technique has been touted as offering substantially faster recovery than other methods of THA, but direct comparison studies in similar groups of patients have not been done. We sought to determine if there was a difference in the early functional outcome after a two-incision THA compared to a mini-posterior THA as measured by the time to reach defined milestones of daily activity. We also evaluated which procedure the patients preferred. Twenty-six patients underwent staged bilateral total hip arthroplasties with a two-incision minimally invasive THA on one hip and a mini-posterior THA on the contralateral hip. The same comprehensive anesthesia and rapid rehabilitation protocol was used after each operation. Patients were reviewed retrospectively a minimum of 6 months after the second total hip arthroplasty. There were no differences in the time to discontinue ambulatory aids, return to driving, climb stairs, return to work, or walk ½ mile. Sixteen of 26 patients preferred the mini-posterior total hip arthroplasty and two patients had no preference. The added surgical technical difficulty of the twoincision minimally invasive total hip arthroplasty was not rewarded with an earlier return to functional activities and more patients preferred their mini-posterior total hip arthroplasty.

Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.